Pre-diabetes: Why It Matters and What You Can Do About It

While most of us have a basic understanding of diabetes, its lesser-known predecessor, pre-diabetes, may need some introduction. Also known as impaired glucose intolerance (IGT) or impaired fasting glucose (IFG), pre-diabetes is a precursor to diabetes - a warning sign that you are at risk of developing Type 2 diabetes if you do not manage your health well.

Already with pre-diabetes, there are 430,000 Singaporeans at risk of developing Type 2 diabetes. This is in addition to the 12 per cent of the population already diagnosed with diabetes.¹

Almost all Type 2 diabetics pass through the pre-diabetes stage, where a person experiences heightened blood sugar levels, but not high enough to be diagnosed with Type 2 diabetes.

The main problem is that many of these people didn't know they had pre-diabetes because they were never screened for it. More alarmingly, many go on to become diabetics without knowing for the same reason. To-date, one in three diabetics are unaware they even have diabetes.²

Pre-diabetes can affect both adults and children, which means anyone can develop the condition. However, some factors, such as obesity, living a sedentary lifestyle or having a family history of diabetics, may increase the likelihood of developing the condition.

If not managed well, pre-diabetes can lead not only to Type 2 diabetes, but also other health complications, including heart diseases, blindness, kidney failure, stroke and amputation.

Out of Singapore’s pre-diabetic population, an estimate of one-third will develop diabetes. Another one-third will remain pre-diabetic, and the last one-third, with effort and exercise, can reverse pre-diabetes by making healthy lifestyle changes to bring your blood sugar level back to normal. ³

Known as Asia’s silent killer, Type 2 diabetes is difficult to detect in its early stages, when you are pre-diabetic. There are no clear symptoms, making it essential that you are regularly screened for the disease. Pre-diabetics may also display symptoms of diabetes, such as feeling excessively thirsty and urination, tiredness, blurred vision, or suffering from sores and cuts that are slow to heal.

Early intervention has proven to improve outcomes for chronic illnesses. The AIA Power Critical Cover Study 2019 found that the estimated cost of living with diabetes will increase to at least S$6,000 in additional expenses per person this year. This additional expense associated with managing diabetes was also the highest – almost double the average cost of managing other chronic illnesses.

A good way of checking if you have pre-diabetes would be to go for routine health check-up. If you don’t have a habit of going for regular health check-ups, the government has introduced subsidised health screenings in a bid to encourage citizens to start monitoring their health more. AIA also encourages people to take greater control of their health by understanding their body as well as getting screened and vaccinated for health conditions.

Even in the pink of health, consider protecting yourself with the AIA Power Critical Cover – it is the first in market to cover the diagnosis of Type 2 Diabetes. The plan supports you extensively through the unpredictable event of multiple critical illnesses, from detection in the pre-early stages, diagnosis to relapses.

If you are diagnosed with pre-diabetes, it not the end of the world. According to the Ministry of Health (MOH), lifestyle changes such as modest weight loss, healthy eating and physical activity may be able to reverse pre-diabetes and delay progression to diabetes.

Monitoring Your Health

People with pre-diabetes should get their blood sugar level measured every six months to get a good gauge on how their food intake and current lifestyle affects their health.

People above 40 who have normal blood sugar levels, but with a family history of Type 2 diabetes, should also undergo regular health screenings.

Weight Management

Losing just five to 10 per cent of your body weight, and maintaining a healthy BMI (less than 23kg/m²) can reduce the risk of pre-diabetes progressing to overt diabetes⁴ . It should be noted, however, that fad diets and extreme exercise may not be beneficial as they may result in fluctuating blood sugar levels.

Any weight loss programme should be managed in a healthy and sustainable manner. Eating healthy and being more active are two ways to go about it.

Eating Well

To start off, reducing your meal portions to consume less calories daily will help you lose weight over time. During his National Day Rally this year, Prime Minister Lee Hsien Loong noted that in 1998, Singaporeans were eating 2,100 calories every day – a healthy level. By 2004, this had risen to 2,400 calories and by 2010, it was at 2,600 calories.⁵

Spacing out your meals in terms of time can also help your body regulate its blood sugar levels. After every meal, your body’s sugar levels increase, and it takes about two hours for sugar levels to return to pre-meal levels⁴.

Choosing to eat healthier meals, such as food with healthy fats rather than saturated or hydrogenated fats, is another way to reduce caloric intake. Eating food with slow-releasing carbohydrates or low glycaemic Index (GI), such as non-starchy vegetables, fruits, and whole grains can help keep your blood sugar constant. Cutting out sweetened drinks and high sodium foods will help too.

Staying Active

About half an hour of moderate physical activity everyday can make a significant difference in your life, especially if you do not exercise often. Brisk walking, riding a bicycle to run errands around the neighbourhood, or walking instead of driving and taking the stairs over the lift, are a few examples of moderate physical activities that are easy to achieve.

Set realistic goals and chart out a plan so you can follow it visually. Change does not happen overnight so do not be disheartened if it takes some time for your efforts to yield visible results. These efforts will help in sustaining reduced blood sugar levels, lowering your chances of converting from pre-diabetes to Type 2 diabetes.